Health workers’ Perspective on the Feasibility and Acceptability of the Introduction of AgRDT for COVID-19 in Kisumu County, Western Kenya

COVID-19 pandemic remains a major global public health challenge also in Low- and Middle-Income Countries (LMIC), due to fragile health systems, limited resources and personnel, low testing and counseling capacity, community perceptions, among others. In Kisumu County of Western Kenya, a unique Public Private Partnership (PPP) was rolled-out to increase testing and capacity building by linking private facilities to the ongoing public sector efforts in combating COVID-19. It became increasingly clear that centralized PCR testing for COVID-19 was too labor-intensive, expensive, prone to machine breakdowns and stock-outs of essential reagents, resulting in long turn-around times and sometimes even adaptations of patient selection criteria. A clear need was identified for rapid point-of-care COVID-19 testing (AgRDT). After successful field evaluation, RDT for COVID-19 was offered through the PPP. This paper aimed to understand the health workers perspective on the feasibility and acceptability of the introduction of the AgRDT in Kisumu County. In-Depth Interviews were conducted with selected health workers (n=23) from the participating facilities and analyzed using Nvivo 11 The health workers accepted the use of AgRDT as it enabled the strengthening of the existing health system, increased testing capacity and provided capacity building opportunities. Challenges included poor management of results discrepant with PCR gold standard. The health workers applauded the introduction of AgRDT with the Kisumu County Department of Health as a more realistic and user-friendly approach, leading to fast turn-around times and increased personal safety experience. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The statement should include: • Specific grant numbers. This research was supported by a grant from Achmea Foundation April 15, 2020, grant number 2020.002. PharmAccess is supported by the Netherlands Ministry of Foreign Affairs. • Initials of authors who received each award T.F. Rinke de Wit • Full names of commercial companies that funded the study or authors Not Applicable • Initials of authors who received salary or other funding from commercial companies Not Applicable • URLs to sponsors’ websites Also state whether any sponsors or funders (other than the named authors) played any role in: • Study design KEMRI/CGHR and PharmAccess Foundation developed the research protocol of the study • Data collection and analysis Not Applicable • Decision to publish Not Applicable • Preparation of the manuscript Not Applicable ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approvals and consent to participate The Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH): Institution and Ethical Review Committee provided research and ethical approval with license number IERC.IBlVOL.tt/3SS/20. Additional research and ethical approval was provided by the National Commission for Science, Technology and Innovation (NACOSTI) with License Number ABS/P/20/7959. All participants and selected health facilities provided written consents to participate in the study I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Not Applicable All relevant data are within the manuscript and its Supporting Information files